GABA

PharmaGABA vs GABA when you have histamine issues/MCAS: does pharmaGABA ease physical anxiety or make things worse?

April 15, 2022 By Trudy Scott 35 Comments

If you have histamine issues or MCAS (mast cell activation syndrome) and the low GABA type of physical anxiety (with muscle tension, insomnia and stress eating), you may well want to consider which type of GABA product you use. It may be wise to avoid or use caution with the type of GABA that is produced via fermentation and could actually make your symptoms worse and cause a histamine reaction.

PharmaGABA and GABA (gamma-aminobutyric acid) are the two forms of commercially available GABA products. PharmaGABA is produced via industrial fermentation of the amino acid glutamic acid (glutamate) using Lactobacillus hilgardii. This is the same beneficial bacteria that is used to ferment foods like kimchi, the well-known Korean vegetable fermented product.

However, GABA is not fermented and is a manufactured product. It’s the form I typically have clients start with simply because it’s been around longer than pharmaGABA and I’ve had such excellent results with it.

I’ve also had reliable feedback from folks who have used both, that GABA works best for them. That said, some folks do find that pharmaGABA works better for their needs and I recognize that there is no one-size-fits-all.

How probable is it that someone could have a histamine reaction to pharmaGABA?

It was only recently that I became aware of the possibility that someone could have a histamine reaction to pharmaGABA. Someone asked the question in my GABA Quickstart online group program and I posed the question to folks on Facebook. Today I’m sharing some of that feedback and asking you to please contribute to the discussion so we can all learn.

Based on what I’ve learned so far I believe it’s very feasible and also probable for many individuals who have histamine issues to have a bad response to pharmaGABA. Keep in mind, histamine triggers are not the same across the board, and it’s possible that some individuals may not react initially and may only react as more and more is used. Or they may not not react at all.

Today’s blog is to shine light on the matter because it’s not something I’ve heard about or seen documented in the research or company product specifications or warnings.

PharmaGABA wasn’t tolerated by Calina’s daughter: she had increased ADHD, agitation, rages, tics and was argumentative and very emotional

Calina shared this about her daughter’s reaction to pharmaGABA and asked about a GABA product that isn’t fermented:

My daughter has high histamine and did not tolerate the pharmaGABA at all. She has increased ADHD, agitation, rages, constantly starts arguments, tics and is very emotional. She has the same reactions with fermented foods (like sauerkraut).

Calina shared that she is 20 and was diagnosed with MCAS at 2 years old:

It improved some for many years, but she’s always been very short attention span, anxiety, OCD, ODD, and learning differences.

Her daughter has a number of more recent factors that are likely compounding things for her:

In 2017 after a mold exposure, dog bite, mosquito bites that left bullseye rashes, all of those symptoms intensified to the extreme.

She used to eat sauerkraut daily but became intolerant. She’s always had problems with all fermented foods and supplements.

I suspect her daughter does have a histamine reaction to pharmaGABA. The clue for me is that her reactions to pharmaGABA are the same as when she consumes fermented foods.

And the symptoms are more severe and more varied than what we see when too much GABA or too much pharmaGABA is used. With too much of either we see increased anxiety and/or more sleepiness and/or feeling flushed. Flushing is common with histamine issues/MCAS and it can be challenging to figure out cause and effect, but this mom and daughter have been dealing with this for a long time and are more likely able to identify what is causing what.

If her daughter has low GABA anxiety physical type symptoms (with insomnia, spinning/focus issues, intrusive thoughts, panic attacks, stiff and tense muscles) I would recommend a GABA-only product, with manufactured GABA instead of fermented pharmaGABA.

PharmaGABA didn’t work for Bren and caused a migraine the next day

A common sign of histamine intolerance/MCAS is migraines so it’s possible that pharmaGABA could trigger a migraine in someone with histamine issues.

Bren shared this on my Facebook post:

Ah now I think I understand why Jarrow’s GABA Soothe not only didn’t work nearly as well for me as GABA Calm, but I also had a migraine the next day. Thanks so much for that information.

When I asked if she has histamine issues and if a migraine is a typical histamine reaction for her she shared that is really only just learning about histamine issues:

Until recently I would have said no and have only had the vaguest idea of what that might mean. But I have been struggling to get off Seroquel, which is the reason I started taking GABA, and I recently found out that Seroquel is a potent anti-histamine. So when you posted about people having histamine issues with the pharmaGABA, which seemed to have caused my migraine, I put 2 and 2 together. I may have it all wrong, but if so it is quite a coincidence.

In Bren’s case it’s a bit more challenging to tease out since this is new to her, she doesn’t eat sauerkraut because she doesn’t like them, but she feels there may be other foods that are affecting her.

This Jarrow GABA Soothe product also contains theanine and Ashwagandha extract so it’s hard to know if it was the pharmaGABA itself. In this instance confirming her reaction with a pharmaGABA only product would be better.

Quetiapine, sold under the brand name Seroquel, is an atypical antipsychotic medication and Bren started to make the connections when she saw my question and because she had read about Seroquel being a histamine-blocking medication.

I share her example because you may not know if you have histamine issues but you may have had a less than pleasant reaction. This will hopefully give you some things to think about.

Product labeling of pharmaGABA can be confusing

You may have noticed this product, Jarrow GABA Soothe, has GABA on the front of the bottle and strangely has “Gamma-amino butyric acid (GABA) (PharmaGABA)” on the product label.

This label makes no sense at all and is contributing to consumer and practitioner confusion.

Unfortunately this kind of labeling is not unusual and variations of this is common with many products.

GABA is used interchangeably with pharmaGABA all the time. In fact, I do it here on the blog and did it in my book. Maybe we are going to find we need to be specific.

Is the flush reaction from too much GABA or because of a histamine reaction?

The biggest issue I see with GABA and pharmaGABA is using too high a dose to start. This causes a temporary and uncomfortable tingling niacin-like flush sensation (in the brain and body).

One challenging aspect is figuring out if the flush reaction is from too much pharmaGABA, or if it’s due to a histamine reaction.

I’d suggest lowering the pharmaGABA dose and looking at all the adverse symptoms. For example, the symptoms of increased ADHD, agitation, rages, tics, being more argumentative and very emotional experienced by Calina’s daughter would not be attributed to too much pharmaGABA but to a histamine reaction (especially when correlated with her similar reactions to high histamine foods.)

If you’re new to histamine issues and MCAS

If you’re new to histamine issues and MCAS (mast cell activation syndrome), Dr. Jill Carnahan has an excellent overview here – Mast Cell Activation Syndrome: Here’s What You Need to Know When Histamine Goes Haywire.

Mast cell activation syndrome is an immune disorder. It’s just one type of mast cell activation disease.

What sets MCAS apart from other mast cell activation diseases is that it isn’t caused by an abnormally large amount of mast cells, and it isn’t a result of pathogen infection. Instead, when you have MCAS, you have a normal amount of mast cells, but they’re overactive and malfunctioning.

When your body is exposed to what it thinks is a threat, these overactive mast cells start to go haywire and secrete massive amounts of chemical mediators stored in the cytoplasm of your cells—degranulation. What’s meant to be a positive, protective response from your mast cells instead triggers both local and systemic negative effects.

When chemical messengers are released into your body, they set off an alarm that triggers an immune system response. And when this response becomes chronic—the chemical messengers are set off too much, too often—the result is mast cell activation syndrome.

In this instance, because pharmaGABA is fermented (and is likely high in histamine for this reason), it’s perceived to be a threat and causes adverse symptoms.

Over the next few months I’ll be sharing additional information about histamine issues and MCAS because of the symptoms of anxiety, insomnia, brain fog, depression and racing heart. Stress is a big trigger and teasing out the role and interplay of neurotransmitter support with GABA and tryptophan is of value.

Resources if you are new to using GABA or pharmaGABA as supplement

If you are new to using the amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see all the low GABA symptoms).

If you suspect low levels of any of the neurotransmitters and do not yet have my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, I highly recommend getting it and reading it before jumping in and using amino acids on your own so you are knowledgeable. And be sure to share it with the team you or your loved one is working with.

I actually write about pharmaGABA briefly because it was new at the time and I had some clients who were seeing success with GABA, also trial pharmaGABA. The results were not as good as when they used GABA, so I continued to use GABA.

The book doesn’t include product names (per the publisher’s request) so this blog, The Antianxiety Food Solution Amino Acid and Pyroluria Supplements, lists the amino acids that I use with my individual clients and those in my group programs.

If you don’t feel comfortable reading my book and figuring things out on your own (doing the symptoms questionnaire and doing respective trials), you can get guidance from me in the GABA Quickstart Program (online/virtual).

If you are a practitioner, join us in The Balancing Neurotransmitters: the Fundamentals program. It’s an opportunity to interact with me and other practitioners who are also using the amino acids.

If you have histamine issues or have been diagnosed with MCAS:

Have you found you can’t tolerate pharmaGABA and do better with GABA for easing physical anxiety, insomnia and/or stress eating?
Are your histamine reactions to pharmaGABA similar to when you eat fermented foods and other high histamine foods?
Please share which pharmaGABA product you used and how much you used
Please share the reactions and the foods that trigger similar reactions so we can build an informal database with the feedback

If you have experienced reactions to pharmaGABA but do well with GABA, do you now have plans to look into the possibility of histamine issues/MCAS? Please share which pharmaGABA product you used and how much you used.

If you’re a practitioner, have you observed these effects with your patients and/or clients and is it something you caution them about?

Feel free to ask your questions here too.

An amino acid supplement with DLPA, glutamine and 5-HTP eases alcohol withdrawal symptoms at an inpatient detoxification program

April 8, 2022 By Trudy Scott 18 Comments

An amino acid supplement with DLPA, glutamine and 5-HTP (and a few other nutrients) eases alcohol withdrawal symptoms at an inpatient detoxification program. Other than anxiety (I’ll share more on this below), there was also a significant decrease in psychiatric symptoms. Here is an excerpt from the study, The use of a food supplementation with D-phenylalanine, L-glutamine and L-5-hydroxytriptophan in the alleviation of alcohol withdrawal symptoms:

We described the use of a food supplementation with D-phenylalanine, L-glutamine and L-5-hydroxytryptophan in the alleviation of alcohol withdrawal symptoms in patients starting a detoxification therapy.

Since abstinence from ethanol causes a hypodopaminergic and a hypoopioidergic environment in the reward system circuits, manifesting with withdrawal symptoms, food supplements that contains D-phenylalanine, a peptidase inhibitor (of opioid inactivation) and L-amino-acids (for dopamine synthesis) were used to replenish a lack in neurotransmitters and alleviate the symptoms of alcohol withdrawal.

First I cover some translation issues and then more about the actual product and study results. I also share my commentary on the amino acids and dosing used in the study (and the fact that anxiety did not resolve). I include how to apply this information if you have a loved one in an alcohol treatment/rehab program or if you recognize social drinking is an issue for you. And I wrap up with additional resources if you are new to using GABA as a supplement, the GABA Quickstart online program and the practitioner training.

The study was completed and published in Slovenia and there are a few translation issues I’d like to clarify:

The study title states D-phenylalanine (DPA) was in the amino acid product, however DL-phenylalanine (DLPA) was actually used. You can read about the difference between DPA and DLPA here. In summary, DPLA works on both dopamine and endorphin support and DPA works on endorphin support only.
As you can see from the excerpt above, hypodopaminergic refers to low dopamine and hypoopioidergic refers to low endorphins. During withdrawal from ethanol/alcohol, both low dopamine and low endorphins cause withdrawal symptoms.
L-5-hydroxytryptophan is incorrectly spelled as L-5-hydroxytriptophan and reward system is incorrectly spelled as reword system. (Clarifications are provided for facilitating online searches in the research literature.)

More about the product, the study and the conclusion

It was a small randomized, double blind study with just 20 patients and the amino acid product was used for 40 days of the inpatient alcohol detox or rehab program.

This is the actual combination product used:

300 mg DLPA

150 mg glutamine

5 mg 5-HTP

1 mg vitamin B6

50 mg calcium gluconate

25 mg magnesium oxide

0.01 mg folic acid

Psychiatric symptoms were measured using the SCL- 90R and included assessing for “somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid, and psychoticism.” During their rehab there was a significant decrease in these categories of psychiatric symptoms in the study group, except for their anxiety symptoms.

The authors conclude that “abstinence causes a major stress for the patients. The use of a food supplement containing D-phenylalanine [it was actually DL-phenylalanine], L-glutamine and L-5-hydroxytryptophan alleviates the withdrawal symptoms.”

As expected, once alcohol consumption was stopped, cortisol levels, liver enzymes and total bilirubin all decreased in the study group and the control group.

My commentary on the amino acids and dosing used in the study (and the fact that anxiety did not resolve)

Keep in mind the same dosing was used for all study participants. What I use clinically with folks with low levels of these neurotransmitters, is an individualized approach based on each person’s needs, for endorphin and dopamine support (from the DLPA), blood sugar support (from glutamine) and serotonin support (from 5-HTP). This means identifying symptoms in each category and doing a trial of each respective amino acid, starting low and increasing based on symptom resolution.

Given that anxiety symptoms didn’t resolve in the study group, I would have loved to see the amino acid GABA included, also dosed according to individual needs. GABA helps ease the physical tension-type anxiety and low GABA tension often drives the need to self-medicate with alcohol in order to relax and fit in socially.

The authors do mention GABA too: “the physiological craving for alcohol may be the result of a deficiency of the naturally occurring opiate like substances as well as other neurochemical deficits (i.e., dopaminergic, GABAergic, and serotonergic).

Also, an animal study shows that GABA helps with gut damage caused by alcohol consumption, so there is this additional benefit.

A higher dose of glutamine and/or 5-HTP may have also helped ease anxiety. They used 150 mg glutamine whereas a typical starting dose for glutamine is 500 mg (and we increase from there). Going up to 1000 mg to 1500 mg three or 4 times a day is not unusual and is typically very beneficial for alcoholics – for blood sugar stability, an additional calming effect and for healing the leaky gut which has been damaged by the alcohol consumption.

With regards to 5-HTP, they used 5 mg 5-HTP which is considered extremely low. I wonder if it was in fact 50 mg, which is a typical starting dose? Going up to 150 mg 5-HTP use 2 or 3 times a day is not unusual. Serotonin support with 5-HTP (or tryptophan) is very beneficial for the worry-type of ruminating anxiety.

For some individuals DLPA may have been too stimulating and contributing to anxiety via a dopamine boost. For these individuals, DPA may have been a better option for endorphin support.

I am not in favor of folic acid and prefer methylfolate, and although magnesium is an important cofactor for neurotransmitter production, magnesium oxide does not provide much usable magnesium.

Outside of the amino acids and other nutrients used, a vitamin B1 (thiamine) deficiency would need to be addressed and any other deficiencies (such as all the B vitamins, zinc, vitamin D, magnesium etc.) caused by chronic alcohol consumption. This is not a comprehensive list and a full functional workup will help to identify all possible deficiencies.

Despite my quibbles, the outcome of the study is very encouraging, I appreciate the researchers and I hope to see it replicated and refined in other settings.

How to apply this information if you have a loved one in an alcohol treatment/rehab program

Unfortunately the amino acids are seldom incorporated at in-patient detox and rehab centers but they should be. Your options are to:

Share this study and my blog with the treatment center
Educate yourself (on using the questionnaire and doing the amino acid trials) so you can use them with your loved one once rehab is over. This is key for preventing a relapse and for swapping alcohol addiction for sugar or caffeine or nicotine addiction.
Introduce one amino acid at a time so you can figure out which one/s they need and how much
Read my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, and share a copy with the treatment center (and your loved one and their treatment team)
Address diet, nutritional deficiencies and gut health

Keep in mind that the amino acids are used with success for cocaine, heroin and other drug addictions.

How to apply this information if you recognize social drinking is an issue for you

New research shares that “low-level alcohol consumption is commonly perceived as being inconsequential or even beneficial for overall health, with some reports suggesting that it may protect against dementia or cardiovascular risks”, however, as the authors suggest “even low-level alcohol consumption is associated with premature brain aging.”

Social drinking is the norm and is way too prevalent. And it’s often used as a calming measure in order to relax and fit in socially. If this sounds like you:

Educate yourself (on using the questionnaire and doing the amino acid trials) so you can use them to quit drinking easily with no willpower and no feelings of being deprived. This is key for preventing the swapping out the need for alcohol (to relax or fit in socially) with a sugar or caffeine or nicotine addiction. In this case, GABA helps a young man who has recently given up alcohol, Adderall and nicotine.
Introduce one amino acid at a time so you can figure out which one/s you need and how much
Read my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, and share a copy with your loved one/spouse/partner and practitioners/therapists.
Address diet, nutritional deficiencies and gut health

Resources if you are new to using the amino acids as supplement

If you are new to using the amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see all the low neurotransmitter symptoms).

There is a section on alcohol but keep in mind that all the sections on sugar craving/addiction apply to alcohol addiction and self-medicating with alcohol too. Some individuals use alcohol to numb out and some use sugar. Many use both and once alcohol addiction is addressed, it’s often replaced with sugar and caffeine addiction. This is why addressing neurotransmitter imbalances is key.

If you are a practitioner, join us in The Balancing Neurotransmitters: the Fundamentals program. It’s an opportunity to interact with me and other practitioners who are also using the amino acids.

Have you used amino acids with success as part of an alcohol detox program (for yourself or for a loved one)? Or to help stop social drinking of alcohol?

Which neurotransmitter imbalances were driving your need to self-medicate with alcohol and which amino acids helped?

If you’re a practitioner do you use the amino acids (via an individualized approach) to help with alcohol withdrawal and cessation with your patients and/or clients?

Feel free to ask your questions here too.

GABA mixed in water and swished in his mouth before a meal prevents esophageal spasms /choking/vomiting, and allows him to swallow

April 1, 2022 By Trudy Scott 24 Comments

GABA mixed in water and swished in the mouth of an adult male, before a meal, prevents his esophageal spasms, and stops his frequent choking and vomiting, and allows him to swallow his food. A colleague shared her husband’s swallowing issues after she read my blog post about using GABA powder inside the check for laryngospasms.

This is what she shared:

That [blog] made me think that [GABA] might be useful for my husband‘s esophageal spasms. He frequently can’t get food down during a meal because of them.

So he started mixing 500 mg GABA in a little water and swishing it around his mouth and then swallowing it at the beginning of each meal. Since he started doing that he has not had one spasm, or vomiting episode.

It’s wonderful to hear about her husband’s success with GABA and this unique application of swishing around GABA powder (mixed in water) in his mouth before a meal (I’ll share more on this aspect below).

I asked if they know what the causes of his esophageal spasms are but they don’t yet know:

We can’t figure it out. It appears to be all food. I would expect there to be a trigger-food, but we can’t find it.

The GABA has completely stopped it. Last night we went out to dinner and he forgot to bring GABA with him and immediately started choking. So he went to the nearest vitamin store, (of which there is only one)! Fortunately it was open. As soon as he got back to the restaurant and took his GABA, he was fine.

GABA does work so well for him and offers him some relief while they continue to search for other underlying root cause/s. Until these are found, GABA is supporting overall low GABA levels, associated with physical tension-type anxiety, intrusive thoughts, stiff and tense muscles in other areas of the body and also stress-eating and self-medicating with alcohol in order to relax. More on low GABA symptoms here.

My input on his dosing and swishing

Regarding the dosing and swishing method I have this input:

500 mg GABA is the ideal dose for his needs but this is considered a high dose to start. For low GABA tension-type anxiety, I have clients start with a trial of 125 mg GABA and go up from there. I’d recommend the same approach for someone with issues like this gentleman experiences.
GABA is most effective when used sublingually or by opening a capsule on to the tongue or by using GABA powder on the inside of a cheek, rather than swallowing a GABA capsule. For this reason, his method of swishing GABA mixed in water is excellent for achieving the spasm-reducing and relaxing benefits quickly. For some folks doing this 30 minutes before a meal may be more effective than doing it right before eating.

The diagnosis can vary from person to person

The diagnosis can vary from person to person. But as long as there are spasms that are affecting swallowing, doing a trial of GABA is worthwhile in order to determine if it will help.

One example is eosinophilic esophagitis where

Clinical manifestations in infants and toddlers generally include vomiting, food refusal, choking with meals and, less commonly, failure to thrive. Predominant symptoms in school-aged children and adolescents include dysphagia (difficulty swallowing), food impactions, and choking/gagging with meals, particularly when comprised of foods with coarse textures. Other symptoms in this patient population include abdominal/chest pain, vomiting, and regurgitation.

The predominant symptom in adults is dysphagia [difficulty swallowing]; however, intractable heartburn and food avoidance may also be present.

One paper, Esophageal microbiome in active eosinophilic esophagitis and changes induced by different therapies discusses the role of the microbiome and how “an increase in levels of gamma-aminobutyric acid (GABA) …is known to exert a role in esophageal motor function.”

Finding the other root causes (other than low GABA)

Regarding finding the root causes, other than low GABA, this is an important aspect that does need to be pursued. Here are some of the many factors worth considering:

Finding food triggers. This can be challenging but an obvious one is gluten which can play a role in eosinophilic esophagitis. Dairy and environmental irritants can be issues too.
GERD/reflux needs to be ruled out or addressed. Food sensitivities are often a factor here too.
Vagus nerve issues can play a role in digestive issues like this. GABA and vagus nerve exercises helped my cough and voice issues. I recorded all my exercises on video and you can find these here. Fortunately I didn’t have any swallowing or choking episodes at that time but have had a choking episode more recently (GABA did help) so I know how scary this can be.
Pyroluria, a social anxiety condition needs to be ruled out or addressed too. This is because nausea, gagging and choking are common symptoms for some individuals.
I’d also consider a tongue tie. I just finished reading Tongue Tied: How a Tiny String Under the Tongue Impacts Nursing, Speech, Feeding, and More (my Amazon link) by Richard Baxter, DMD, MS. The focus on babies and children but adults can also benefit from addressing tongue tie issues later in life.
Addressing gut health and the microbiome may be one of the keys, as outlined in the paper above.

This is not a comprehensive list and a full functional workup will help to identify all possible root causes.

Related blogs: young boy with choking episodes, lump-in-the throat sensation, anxiety and globus pharyngeus

Here are some related blogs that you may find useful

Paroxysmal laryngospasm with low GABA physical-tension-type-anxiety: Is GABA powder rubbed on the inside of the cheek a solution? (this is the blog that inspired my colleague to have her husband do the GABA mouth swishing)
GABA helps a stressed young boy with episodes of “choking” or tightening in his throat
GABA is the answer after 40 years of a lump-in-the-throat sensation, nervousness and muscle tension at work
Anxiety and globus pharyngeus (lump in the throat): GABA to the rescue?

Resources if you are new to using GABA as a supplement

If you are new to using the the amino acid GABA as a supplement, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see the low GABA and other low neurotransmitter symptoms).

If you suspect low levels of GABA or low serotonin and do not yet have my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, I highly recommend getting it and reading it before jumping in and using amino acids on your own so you are knowledgeable. And be sure to share it with the team you or your loved one is working with.

The book doesn’t include product names (per the publisher’s request) so this blog, The Antianxiety Food Solution Amino Acid and Pyroluria Supplements, lists the GABA products that I use with my individual clients and those in my group programs.

If you don’t feel comfortable reading my book, doing the low GABA symptoms questionnaire and doing trials of GABA on your own, you can get guidance from me in the GABA Quickstart Program (online/virtual).

If you are a practitioner, join us in The Balancing Neurotransmitters: the Fundamentals program. It’s an opportunity to interact with me and other practitioners who are also using the amino acids.

Have you experienced throat or esophageal spasms and difficulty swallowing with choking and/or vomiting.

And do you have the low GABA physical-tension-type-anxiety symptoms? What else is a trigger for you and do you have a diagnosis?

If you’ve already been using GABA with success for easing your anxiety, have you noticed a reduction in your swallowing issues?

Have you ever used GABA in this way to help your swallowing issues?

If you’re a practitioner please share what you have seen?

Feel free to ask your questions here too.

Paroxysmal laryngospasm with low GABA physical-tension-type-anxiety: Is GABA powder rubbed on the inside of the cheek a solution?

March 4, 2022 By Trudy Scott 42 Comments

One type of reactive airway obstruction is paroxysmal laryngospasm, which is a rare laryngeal disease in adults. In this condition, the throat is completely closed due to some form of hypersensitivity or a protective laryngeal reflex causing a transient, complete inability to breathe. Paroxysmal laryngospasm onset in patients is often characterized by a sudden and complete inability to breathe, along with voice loss or hoarseness and stridor. Paroxysmal laryngospasm usually lasts from several seconds to several minutes and may be accompanied by obvious causes such as upper respiratory tract infection, emotional agitation or tension, and/or severe coughing.

I shared something similar on Facebook and the fact that this had just happened to me when drinking lemon water and starting to talk too quickly after my last sip. I choked on the lemon water and my vocal cords went into a spasm. I could not breathe and I had a violent coughing fit. It was a terrifying experience! A few dabs of GABA powder inside my cheek helped relax my vocal cords – which are muscles – immediately. I could breathe right away.

I’ve been researching this condition for some time now because I figured out this same solution for a family member who has had this happen about 6 times in the last few years.

The response on Facebook was surprisingly high and I now wonder how common this condition is with those who experience low GABA physical-tension-type-anxiety and if oral GABA powder is a viable solution for more individuals.

The 2020 paper on paroxysmal laryngospasm

The above description comes from this 2020 paper – Paroxysmal Laryngospasm: A Rare Condition That Respiratory Physicians Must Distinguish from Other Diseases with a Chief Complaint of Dyspnea

Let’s review a few terms from the paper:

According to Merriam-Webster, a paroxysm is a fit or attack.
Laryngospasm “(luh-RING-go-spaz-um) is a transient and reversible spasm of the vocal cords that temporarily makes it difficult to speak or breathe”, according to Mayo Clinic
Mayo Clinic describes dyspnea as follows: “Shortness of breath – known medically as dyspnea – is often described as an intense tightening in the chest, air hunger, difficulty breathing, breathlessness or a feeling of suffocation.”
According to Medscape, stridor is “an abnormal high-pitched sound produced by turbulent airflow through a partially obstructed airway.”) It’s particularly distressing to hear.

So essentially the title of this paper could be translated to something like this: An attack of temporary spasms of the vocal cord that causes difficulty breathing (0ften with a distressing sound of suffocating). I would go as far to say: A terrifying attack ….

One of the objectives of the paper is to create more awareness on “how to identify and address paroxysmal laryngospasm from the perspective of respiratory physicians.” The authors share that otolaryngologists (head and neck surgeons) and anesthesiologists (it happens frequently when undergoing anesthesia) are experts in managing paroxysmal laryngospasm.

They also state it’s rare and generally happens when an individual has gastroesophageal reflux disease (GERD), and share how antireflux therapy i.e. PPIs (proton pump inhibitors) are frequently an effective treatment. My input on this: if it is caused by GERD, address why the GERD is happening and avoid PPIs if possible since they contribute to nutritional deficiencies and osteoporosis.

Hysterical stridor in adult females who are anxious and/or depressed

There is no mention of GABA or addressing spasms in the vocal cords and other muscles in this paper. However, the authors do discuss hysterical stridor as being different from paroxysmal laryngospasm, stating “it has a strong demographic pattern of occurring in young adult females, lasting for minutes to hours, frequently requiring sedation or anxiolytics for treatment, and persisting for years.”

They also share this about hysterical stridor:

Psychological assessment usually reveals multiple sources of life stress, compulsive personality traits, depression, anxiety, maladjustment, or a history of psychosomatic comorbidity. Other psychotherapy interventions, such as antianxiety therapy, depression therapy, sedation therapy, speech therapy, and behavioral therapy, are usually effective.

(note: I’m not thrilled by the term hysterical stridor. The diagnosis of hysteria goes back to the 1880s.)

I’m proposing oral GABA powder be researched as another viable option to address the low GABA anxiety symptoms, the hysterical stridor and the paroxysmal laryngospasm.

Is paroxysmal laryngospasm/hysterical stridor really that rare?

I do wonder if these conditions are really that rare. When I shared my experience on Facebook I had a reasonably big response from people saying it’s happened to them a few times, with some saying it has been happening all their lives. Here are a few of the many examples:

Anita shared this: “I have experienced laryngospasm. The experience is a spasmodic tightening of the airway triggered by ‘swallowing wrong’ for me. I have never experienced laryngospasm aside from that. I do have low GABA symptoms of physical tension and have had intrusive thoughts in the past, stress eating, but have never used ‘wine to relax’ as I am a ‘teetotaler.’ The episodes I’ve experienced have always resolved on their own within a minute or so. Scary feeling – that is for sure! I plan to keep GABA powder on hand now just in case of a future episode.”
Megan shared this: “I have Laryngospasm. I have total throat closure. It feels like forever but I suppose it’s up to 50 seconds. I’ve had it since I was a child and my mum has it too. Food is probably my main trigger, crumbly or syrup type things, a bad cold or even just swallowing wrong. I had a look at the list and I have quite a lot of the low GABA symptoms. I have generalized anxiety, feeling worried/fearful, panic attacks (but they are under control with Zoloft), tense stiff muscles, feeling stressed and burnt out, intrusive and unwanted thoughts and acrophobia.”

One woman felt she had experienced paroxysmal laryngospasm and she had been told it was a panic attack. A few people mentioned a similar condition called vocal cord disorder (often exercised- induced). Many said they had received no diagnosis or help from their doctor.

Interestingly, there are not many papers on “paroxysmal laryngospasm” or “hysterical stridor” so the research and presumably awareness too, seems to be lacking.

Why did I consider GABA for paroxysmal laryngospasm?

You may wonder why I considered GABA when this happened to me. I’ve personally used GABA with success over the years for spasms in my back muscles, rectal muscle spasms/proctalgia fugax, and vagus nerve and coughing/throat spasm episodes. With the additional knowledge I’ve now gained I suspect the latter was a form of laryngospasm.

I’ve also shared how GABA helps ease globus pharyngeus (a lump-in-the-throat sensation that is associated with anxiety and something I experienced in my late 30s).

I’m prone to low GABA physical-tension-type anxiety and have always done really well with oral sublingual GABA.

And of course, when you look at the low GABA symptoms all this makes perfect sense. GABA helps with muscle spasms and provides pain relief when muscles are tight. The vocal cords are muscles and the larynx itself contains many muscles.

In case you’re new to GABA, it is a calming amino acid, used as a supplement, to ease low GABA levels. With low GABA you’ll experience physical-tension and stiff-and-tense-muscles type of anxiety, panic attacks and insomnia. You may feel the need to self-medicate to calm down, often with alcohol but sometimes with carbs and sugary foods.

What GABA did I use and how did I use it?

I dumped some GABA powder on the palm of my hand (with the help of a family member who rushed to my aid). I wet my finger with saliva, dabbed it in the GABA powder and rubbed it on the inside of my cheek. I did this a few times.

I don’t know exactly how much I used in total but estimate it to be around 200 mg GABA. I stopped rubbing it on the inside of my cheek as soon as I felt the muscles relaxing and I was able to breathe easily again. It felt like forever but it probably only lasted 30-60 seconds. I’d assume a more intense paroxysmal laryngospasm may require more GABA.

It was really encouraging how quickly GABA relaxed the muscles and stopped the laryngospasm. It’s also taken away the fear about it happening again.

Resources if you are new to using GABA as a supplement

If you don’t feel comfortable reading my book, doing the low GABA symptoms questionnaire and doing trials of GABA on your own, you can get guidance from me in the GABA Quickstart Program.

If you are a practitioner, join us in The Balancing Neurotransmitters: the Fundamentals program. It’s an opportunity to interact with me and other practitioners who are also using the amino acids.

Have you experienced paroxysmal laryngospasm? And do you have the low GABA physical-tension-type-anxiety symptoms? What else is a trigger for you?

If you’ve already been using GABA with success, have you noticed a reduction in the paroxysmal laryngospasm episodes?

Have you ever used GABA in the way I did to stop an episode quickly?

Have you received a diagnosis and if yes, what diagnosis?

If you’re a practitioner please share what you have seen?

Feel free to ask your questions here too.

How much GABA should I use for my anxiety? It depends on your unique needs (and there is an extremely large variation in dosing)

February 25, 2022 By Trudy Scott 55 Comments

GABA is a calming amino acid, used as a supplement, to ease low GABA levels. With low GABA you’ll experience physical-tension and stiff-and-tense-muscles type of anxiety, panic attacks and insomnia. You may feel the need to self-medicate to calm down, often with alcohol but sometimes with carbs and sugary foods. GABA also helps with muscle spasms and provides pain relief when muscles are tight.

One of the most common questions I get from individuals who are excited to hear about the benefits of GABA but are totally new to using this amino acid is: “How much GABA should I use for my anxiety?” Even individuals who may be familiar with GABA and have even experimented with it themselves and are seeing some benefits may also have this question.

Most are not aware of the extremely large variations in dosing that may work for different individuals. Today I’ll share some examples to illustrate both the wonderful benefits and this range of dosing which can be as much as a 1000x to 2000x variation in some instances!

Syd gets sleep and body anxiety benefits with just 1.5 mg to 3 mg GABA

As you can see in this first example, Syd gets sleep and body anxiety benefits with just 1.5 mg to 3 mg GABA. She shared this on a recent blog post where I discussed how using too much GABA can cause a niacin-like flushing sensation

I think it’s useful to note that some, like me, start out with tiny doses and still get benefits with no side effects. I take around 1.5 mg to 3 mg GABA at a time and it works for me! Really helps me sleep at night.

I also take approximately 1.5mg if I feel body anxiety. I divide a melt-able 25mg tablet into 8ths or less. (Very approximate, of course. Sometimes it’s just crumbs!)

Right now, anything higher and I’m a wet noodle the next day, meaning I feel super depleted and can hardly stand up. But, no niacin flush-like symptoms.

I appreciate her sharing and I’m so glad she found her ideal dose. As you can see it’s really really low. We call folks like Syd “pixie dust” people because they do really well with tiny tiny doses. It also shows that some folks get flushed with too much GABA and some don’t. Syd just feels depleted.

In case you’re wondering which product Syd is using, it’s the Kal 25 mg GABA, which she breaks apart.

To give this perspective, a typical starting dose is 125mg GABA for adults and half that for children. I share more below on this and how to use the symptoms questionnaires and do a trial.

Christina’s agoraphobic client was able to leave the house with 3000 mg GABA

A colleague, Christina Veselak, MS, LMFT, CN shared this feedback about her client who had agoraphobia i.e. fear of outdoor spaces:

I once had a profoundly anxious, agoraphobic client who I sent home with instructions to trial GABA until she either got relief from her anxiety or an adverse reaction. She came back a few days later to say that she had arrived at 3000 mg of GABA in the morning as her ideal dose.

That dose allowed her not only to leave her bedroom but also leave her house, socialize and babysit her hyperactive grandsons!

Most of my other clients could not tolerate anything near to that dose without getting an adverse reaction but it was perfect for her.

This really adds perspective to the range of doses that folks may respond to. This dosage is 1000x higher than Syd’s maximum dose and 2000x higher than her lowest dose!

Let’s address this question: How much GABA should I use for my anxiety?

The answer is this – it depends on your unique needs and biochemistry. I know it’s not the answer you (and almost everyone else too) probably want to hear but there really is no one-size-fits-all when it comes to GABA and the other amino acids.

The best way to determine if you may have low GABA and may benefit from using GABA is to look at the low GABA symptoms, rate them on a scale of 1-10, with 10 being worst, do a trial of GABA and rate the symptoms again right afterwards (in the next 2 to 30 minutes).

Here are the symptoms.

From there you continue to adjust up (or down) over the next few weeks to find your ideal dose. If you go too high you may experience an uncomfortable tingling niacin-like flush.

I can share this: for GABA, 125mg is a typical starting dose for adults that I use with my clients. Half that or less is a good ballpark for starting a trial for children. As with all the amino acids, they are always best used sublingually and taken away from protein.

Below is an example from someone who figured out 1-3 of the 125 mg GABA Calm product was ideal for her own needs.

Melissa is much calmer, sleeps well and stopped craving sweets with 125 mg to 375 mg GABA Calm a day

Melissa started using Source Naturals GABA Calm in anticipation of holiday travel and holiday gatherings and shared how much she benefited:

I have been taking 1-3 per day for two weeks. I’m glad I bought it before traveling home for Christmas – I was cool as a cucumber at the airport and was much calmer when visiting family and friends compared to last year!

The true test of its efficacy will be in two weeks when the semester starts. For now, I notice a general calmness and am sleeping well.

An unexpected result was that I stopped craving sweets after about a week of taking it!

And how wonderful for her! And we have much appreciation for her sharing her success.

These results at this dosage are pretty typical for the majority of my clients. Of course there may need to be adjustments seasonally (possibly needing less after the holidays and closer to spring) or more around her period or more with added stresses in her life.

You can read more about the GABA Calm product she used here (you can find it in my online supplement store too).

Resources if you are new to using GABA as a supplement

If you don’t feel comfortable reading my book, doing the low GABA symptoms questionnaire and doing trials of GABA on your own, you can get guidance from me in the GABA Quickstart Program.

If you are a practitioner, join us in The Balancing Neurotransmitters: the Fundamentals program. AS you’ve learned today, there are many nuances and best practices when using the amino acids. And it’s an opportunity to interact with me and other practitioners who are also using the amino acids.

What have you found to be your ideal dose of GABA? And how has it helped you?

What dose did you start with and did you go too high and then have to back down again to get to your ideal dose? (be sure to share which product worked for you too)

Are you surprised to learn about this huge variation in dosing GABA? And if yes do you feel inspired to experiment with your current dosing?

If you’re a practitioner have you seen these variations?

Feel free to ask your questions here too.

Too much GABA causes a tingling niacin-like flush sensation (in the brain and body). It’s awful and very uncomfortable!

February 18, 2022 By Trudy Scott 104 Comments

GABA, used as an amino acid, helps to raise GABA levels and ease physical tension-type anxiety. There are many misunderstandings on the best and most effective ways to use GABA and this can lead to unpleasant symptoms. One common thing I see is that too much GABA causes the brain and body to react with a tingling niacin-like flush sensation that is very uncomfortable and often described as awful.

Too many people stop using GABA for this reason. And then they lose out on the wonderful calming benefits of this amino acid. Some folks actually push through and continue with the unpleasant tingling sensation because they don’t know better and because they are also getting some of the calming benefits of GABA (I share an example of this below). Neither situation is ideal.

I recently received a GABA question on the blog on this very topic. It was from a licensed acupuncturist in California, USA (let’s call her Dr. M):

When I used to take GABA for my stress, my body/brain reacted with a tingling sensation.

It was so awkward and uncomfortable.

I thought it was only me, but when I prescribed GABA to my patients, they also felt the same sensations.

Can you tell me why this reaction occurred?

Thank you so much for your generosity and deep research.

Because this is such a common question that I get, I’m sharing it and my responses to use it as a teaching opportunity.

Too much GABA can cause this uncomfortable tingling niacin-like flush or sensation

I responded sharing that it can happen when too much GABA is used or if GABA is not needed. I typically hear of this happening when 500mg to 750mg is used to start. It’s also often described as a niacin-like flush. With GABA, 125mg is a typical starting dose and it’s always used as a sublingual or capsule opened onto the tongue. We slowly go up from there based on symptoms and the final dose is unique to each person’s needs. You may end up using 500mg or more but it’s a slow approach to get there.

I asked Dr. M to share which product/s she used, the dosing and let me know if she does better with a lower dose.

As expected she was using too high a dose (and hadn’t done a trial of a lower dose). She responded with this feedback:

The GABA I used for me and my patients is from Pure Encapsulations. This GABA contains 700 mg per capsule, which may be too much for the start.

Which brand would you recommend for practitioner use?

I responded by confirming that 700 mg GABA is way too much to start for most people.

What product and how much to use instead of 700 mg GABA

I like the Pure Encapsulations product but I actually feel the companies are partially at fault for having such high dose products, stating “1 capsule daily, between meals, or as directed by a health professional” on the label, and not educating practitioners and consumers about this issue.

With a product like this I have clients open up the capsule and start with 125 mg GABA powder on the tongue and increase from there as needed.

I also shared the other GABA products I use in case she would prefer to try something like the Source Naturals GABA Calm product I frequently use with clients.

This is a lozenge that contains 125 mg GABA, 5 mg magnesium, 50 mg glycine, 25 mg tyrosine and 20 mg taurine. This is my most popular and most effective form of GABA I use with my clients. [Note: this product is a lozenge with 125mg GABA and is not to be confused with the Source Naturals, GABA Calm Mind, 750 mg tablets]

I’m waiting for feedback from her to hear how using less of the 700 mg GABA (opened up and divided out) or how using another GABA product works for her and her patients.

I do appreciate Dr. M for asking a tough question like this and being open to me sharing so everyone gets to learn.

Where did Dr. M learn about GABA and some resources for additional practitioner education

I did ask Dr. M where she learned about using GABA and if the recommendation was to use a high dose like this. I’m genuinely curious to know so I can help guide further education in the use of GABA.

Of course, I encouraged her to get my book “The Antianxiety Food Solution” and read the chapter on the amino acids. And to consider signing up for the amino acid training for practitioners. There are many nuances and best practices when using the amino acids. And it’s an opportunity to interact with me and other practitioners who are also using the amino acids.

If you’re a practitioner, I’m hoping this question, my feedback and these resources are helpful for you.

Similar niacin-like flush experienced by Holly

As mentioned above this is a very common issue because most GABA products are 500mg and up and folks hear how amazing GABA is for physical anxiety and use a high dose without understanding they need to start low and use only what they need.

I shared my discussion with Dr. M in a Facebook post and Holly responded with what happened to her when she switched from GABA Calm (which has 125 mg GABA) to a 750 mg GABA product:

I experienced the niacin-like flush when I tried to go from GABA Calm [mostly dissolved in my mouth] to a pill form and didn’t realize the dosage would be way too high all at one time. The pill was 750 mg GABA [and swallowed with food], so it wasn’t going to work well anyway.

The flush lasted about 15-20 minutes. It was awful. I was sure I was going to throw up every time.

It took me a couple of weeks to figure out the cause. My therapist recommended your website and book and those helped me understand when to take it and why it would help.

When I eliminated the 750 mg GABA pill the symptoms completely went away.

Now I stick to GABA Calm. I take one in the morning and one before bed and sometimes one midday.

I appreciate Holly for sharing and I’m glad her and her therapist figured it out.

Resources if you are new to using GABA as a supplement

If you are new to using the the amino acids GABA as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see the low GABA and other low neurotransmitter symptoms)

In case you’re new to the low GABA-type of anxiety, with low GABA levels you may experience physical-tension and stiff-and-tense-muscles, panic attacks, more physical tension in certain settings like public speaking or driving. You will often have the need to self-medicate to calm down, often with alcohol but sometimes with carbs and sugary foods.

Insomnia can also be caused by low GABA and you’ll experience physical tension in bed at night rather than the ruminating thoughts which is the low serotonin type of insomnia (although it’s not uncommon to experience both.) GABA also helps with muscle spasms and pain relief when muscles are tight.

Get guidance in the GABA QuickStart Program

If you don’t feel comfortable reading my book, doing the low GABA symptoms questionnaire and doing trials of GABA on your own, you can get guidance from me in the GABA Quickstart Program.

We have an active and engaged community in the private Facebook group and there are 2 live Q & A calls with me.

One of the recent participants shared this lightbulb moment after starting with GABA Calm in the day and then shifting to 250 mg GABA at night only:

Listening to the GABA Quickstart made me realize something about the Source Naturals GABA Calm with the bit of tyrosine. I bought the NOW GABA powder and last night took 250mg (1/8 tsp and I have tiny measuring spoons) and woke up great.

I think I found my dose of GABA and I don’t think after my trial I’m a GABA in the day girl.

Have you used a high dose of GABA to start (or switched to a higher dose like Holly did) and experienced this unpleasant niacin-like flush?

How much caused this tingling sensation for you and how unpleasant was it? Did you push through and continue using the high dose? Or did you figure it out and use less? How long did it take you to figure it out?

Maybe you quit using GABA because of something like this – do you now feel inspired to try again?

If you’ve had success with using GABA please do share too.

If you’re a practitioner where did you learn about using GABA and was the recommendation was to use a high dose like 500 mg or 750 mg to start?

Feel free to ask your questions here too.

Be sure to share which product you used, how much you used and if you have low GABA symptoms.